COVID-19 primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2] Tayyaba Ali, M.D.[3]

Overiew

There is currently no vaccine to prevent COVID-19. The best way to prevent infection is to avoid being exposed to this virus. The fact that it is currently flu and respiratory disease season, CDC recommends getting a flu vaccine, taking everyday preventive actions to help stop the spread of germs, and taking flu antivirals if prescribed. Healthcare providers are advised to be on the look-out for people who recently traveled from China and have fever and respiratory symptoms.

Primary Prevention

Exposure Control

2019-nCoV

There is currently no vaccine to prevent COVID-19. The best way to prevent infection is to avoid being exposed to this virus. The following practices should be adopted for infection control:[1]

  • Hand washing often with soap and water for at least 20 seconds.
  • Using an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available
  • FDA advises consumers not to use any hand sanitizer manufactured by Eskbiochem SA de CV in Mexico, due to the potential presence of methanol (wood alcohol), a substance that can be toxic when absorbed through the skin or ingested. FDA has identified the following products manufactured by Eskbiochem:[2]
    • All-Clean Hand Sanitizer (NDC: 74589-002-01)
    • Esk Biochem Hand Sanitizer (NDC: 74589-007-01)
    • CleanCare NoGerm Advanced Hand Sanitizer 75% Alcohol (NDC: 74589-008-04)
    • Lavar 70 Gel Hand Sanitizer (NDC: 74589-006-01)
    • The Good Gel Antibacterial Gel Hand Sanitizer (NDC: 74589-010-10)
    • CleanCare NoGerm Advanced Hand Sanitizer 80% Alcohol (NDC: 74589-005-03)
    • CleanCare NoGerm Advanced Hand Sanitizer 75% Alcohol (NDC: 74589-009-01)
    • CleanCare NoGerm Advanced Hand Sanitizer 80% Alcohol (NDC: 74589-003-01)
    • Saniderm Advanced Hand Sanitizer (NDC: 74589-001-01)
  • Avoid touching eyes, nose, and mouth with unwashed hands
  • Avoid close contact with people who are sick
  • Stay home when symptomatic
  • Cover cough or sneeze with a tissue paper, then throw the tissue in the trash
  • Clean and disinfect frequently touched objects and surfaces
  • Protective clothing:
    • Lab coats, gloves when direct skin contact with infected materials or animals is unavoidable
    • Eye protection must be used where there is a known or potential risk of exposure to splashes
  • Miscellaneous:
    • All procedures that may produce aerosols, or involve high concentrations or large volumes should be conducted in a biological safety cabinet (BSC)
    • The use of needles, syringes, and other sharp objects should be strictly limited. Additional precautions should be considered with work involving animals or large scale activities
    • Disinfect surfaces with 75% ethanol, peracetic acid, chlorine, and UV disinfection or hot water bath at 56 °C(132.8 °F) for 30 minutes

Public Policy

Interventions to mitigate early spread of SARS-CoV-2 in Singapore: a modelling study by the Singapore Ministry of Health in 2020 stated[3]:

  • “Implementing the combined intervention of quarantining infected individuals and their family members, workplace distancing, and school closure once community transmission has been detected could substantially reduce the number of SARS-CoV-2 infections.”
  • “Quarantine and workplace distancing should be prioritized over school closure because at this early stage, symptomatic children have higher withdrawal rates from school than do symptomatic adults from work”
  • “At higher asymptomatic proportions, intervention effectiveness might be substantially reduced requiring the need for effective case management and treatments, and preventive measures such as vaccines.”

The projected benefit of social distancing is: Reduced local and global total COVID-19 spread and related mortality

Similar findings have been modeled by the Medical Research Council (MRC) Centre for Global Infectious Disease Analysis and WHO Collaborating Centee for Infectious Disease Modelling[4].

Other preliminary research is available[5] including the impact of population mobility as measured with real-time human mobility data from an Internet provider (Baidu)[6].

Human mobility has been measured by the Internet provider Baidu and Unacast.

Handling and Storage

CDC Recommendations Regarding COVID-19

  • While the immediate risk of this new virus to the American public is believed to be low at this time, everyone can do their part to help in responding to this emerging public health threat:[7]
  • The fact that it is currently flu and respiratory disease season, CDC recommends getting a flu vaccine, taking everyday preventive actions to help stop the spread of germs, and taking flu antivirals if prescribed.
  • Healthcare providers are advised to be on the look-out for people who recently traveled from China and have fever and respiratory symptoms.
  • Healthcare providers caring for 2019-nCoV patients or public health responders are advised to take care of themselves and follow recommended infection control procedures.
  • People who have had close contact with someone infected with 2019-nCoV and are symptomatic should contact their healthcare provider and tell them about their symptoms and exposure to a SARS-CoV-2 patient.
  • In areas where SARS-CoV-2 is prevalent, all residents should be encouraged to remain alert for symptoms and practice social distancing by staying home the maximum amount as possible and maintaining six feet (two meters) distance from others once they must leave the house.[8]
  • For those strolling back from international travel (including sea trip) and people who have had close contact with a patient with suspected or confirmed COVID-19 (including during the 48 hours before that patient developing symptoms), CDC recommends self-quarantine at home for 14 days and has emphasized n maintaining six feet (two meters) distance from others family members.
  • During the self-quarantine after returning from travel, contacting individuals at high risk for severe illness (unless they are household members with the same exposure) should be avoided.
  • During the self-quarantine, the temperature should be checked twice daily with monitoring for fever, cough, or dyspnea. If they develop such clinical manifestations, they must still reside home far from other household members and call their medical providers.[9][10]
  • During the 14-day post-exposure period, asymptomatic individuals can return to work with symptom and temperature monitoring, mask use, social distancing, and workplace disinfection.[11]

References

  1. https://www.cdc.gov/coronavirus/2019-ncov/index.html. Missing or empty |title= (help)
  2. https://www.fda.gov/drugs/drug-safety-and-availability/fda-advises-consumers-not-use-hand-sanitizer-products-manufactured-eskbiochem.html. Missing or empty |title= (help)
  3. Koo JR, Cook AR, Park M, Sun Y, Sun H, Lim JT; et al. (2020). "Interventions to mitigate early spread of SARS-CoV-2 in Singapore: a modelling study". Lancet Infect Dis. doi:10.1016/S1473-3099(20)30162-6. PMC 7158571 Check |pmc= value (help). PMID 32213332 Check |pmid= value (help).
  4. Ferguson, N.; Laydon, D.; Nedjati Gilani, G.; Imai, N.; Ainslie, K.; Baguelin, M.; Bhatia, S.; Boonyasiri, A.; Cucunuba Perez, Zulma; Cuomo-Dannenburg, G.; Dighe, A.; Dorigatti, I.; Fu, H.; Gaythorpe, K.; Green, W.; Hamlet, A.; Hinsley, W.; Okell, L.; Van Elsland, S.; Thompson, H.; Verity, R.; Volz, E.; Wang, H.; Wang, Y.; Walker, P.; Winskill, P.; Whittaker, C.; Donnelly, C.; Riley, S.; Ghani, A. (2020-03-16). Report 9: Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand. Retrieved 2020-03-25.
  5. Lai, Shengjie; Ruktanonchai, Nick W; Zhou, Liangcai; Prosper, Olivia; Luo, Wei; Floyd, Jessica R; Wesolowski, Amy; Santillana, Mauricio; Zhang, Chi; Du, Xiangjun; Yu, Hongjie; Tatem, Andrew J (2020). "Effect of non-pharmaceutical interventions for containing the COVID-19 outbreak in China". doi:10.1101/2020.03.03.20029843.
  6. Kraemer, Moritz U.G.; Yang, Chia-Hung; Gutierrez, Bernardo; Wu, Chieh-Hsi; Klein, Brennan; Pigott, David M.; du Plessis, Louis; Faria, Nuno R; Li, Ruoran; Hanage, William P.; Brownstein, John S; Layan, Maylis; Vespignani, Alessandro; Tian, Huaiyu; Dye, Christopher; Cauchemez, Simon; Pybus, Oliver; Scarpino, Samuel V (2020). "The effect of human mobility and control measures on the COVID-19 epidemic in China". doi:10.1101/2020.03.02.20026708.
  7. https://www.cdc.gov/coronavirus/2019-nCoV/summary.html. Missing or empty |title= (help)
  8. [+https://www.cdc.gov/coronavirus/2019-ncov/php/public-health-recommendations.html+ "Public Health Guidance for community-related Exposure | CDC"] Check |url= value (help). Retrieved 7/12/2020. Check date values in: |accessdate= (help)
  9. [+https://www.cdc.gov/coronavirus/2019-ncov/php/public-health-recommendations.html+ "Public Health Guidance for community-related Exposure | CDC"] Check |url= value (help). Retrieved 7/12/2020. Check date values in: |accessdate= (help)
  10. "Public Health Guidance for Potential COVID-19 Exposure Associated with International Travel or Cruise Travel | CDC". Retrieved 7/12/2020. Check date values in: |accessdate= (help)
  11. "Implementing Safety Practices for Critical Infrastructure Workers Who May Have Had Exposure to a Person with Suspected or Confirmed COVID-19 | CDC". Retrieved 7/12/2020. Check date values in: |accessdate= (help)